The Lumbar and Thoracic Spine: General Info

Question 1

Spondylosis = the degeneration of ____?

Answer 1

IVD

Question 2

Spondylolysis = The degeneration of what structure in the spine?

Answer 2

Pars interarticularis

Question 3

How does Spondylolysis occur? What direction does the spine have to move in order to result in this injury?

Answer 3

Hyperextention

Question 4

Spondylolisthesis = a injury to the spine occurs where ? happens?

Answer 4

Forward displacement of one vertebrae over another.

Question 5

If the IVD is starting to degenerate this is called?

Answer 5

Spondylosis

Question 6

If a fracture occurs in the in the spine at the pars interaticularis what is this injury called?

Answer 6

Spondylolysis aka scotty dog fracture

Question 7

When one is becomes forwardly displaced over another disc what is this called?

Answer 7

Spondylolisthesis

Question 8

The role of the __?__ is to stabilize the spine, allow limited movement, and protect the intervertebral discs from shear forces caused by excessive forward bending, back bending, and rotation.

Answer 8

facet joints

Question 9

What are the 4 different levels of possible injury to the discs of the spine?

Answer 9

Protrusion
Prolapse
extrusion
sequestration

Question 10

What does it mean if a disc is in protrusion?

Answer 10

The nucleus pulposus has gone from a round shape to oval but it hasn’t ruptured through the annulus fibrosus.

Question 11

What does it mean if a disc has prolapsed?

Answer 11

The nucleus pulposus has broken through most of the fibers of the annulus fibrosus. Only the very outer fibers contain it.

Question 12

What does it mean if a disc is extruding?

Answer 12

The nucleus pulposus has ruptured through the annulus fibrosis fibers and is bulging into the spinal canal.

Question 13

What does it mean if the disc is in sequestration?

Answer 13

The nucleus pulposus has ruptured through the annulus fibrosis and fragments are freely floating in the spinal canal

Question 14

What is it called when the nucleus pulposus goes from round to oval?

Answer 14

protrusion

Question 15

What is it called when the nucleus pulposus breaks through part of the annulus fibrosis and only the outer fibers of containing it?

Answer 15

Prolapse

Question 16

What is it called when the nucleus pulposus rupture completely through the annulus fibrosis and bulges into the spinal canal?

Answer 16

Extrusiton

Question 17

What is it called when the nucleus pulposus ruptures through the annulus fibrosis and fragments are freely floating into the spinal canal?

Answer 17

Sequestration

Question 18

What are some activities that increase pressure in the low back?

Answer 18

walking
small jumps
laughing
lifting weight with back straight/ bent

Question 19

What puts more pressure on your back lifting a weight with your back bent or straight?

Answer 19

Bent back = more pressure

eg lift with your knees not your back

Question 20

what is the closed packed position of the low back?

Answer 20

extention

Question 21

what is the open packed position of the low back?

Answer 21

mid way between flex/ ext

Question 22

What other joints should you rule out first before testing the lumbar/ Thoracic spine?

Answer 22

Hip : AF flexion/ medial rotation w over pressure
Pelvis: rocking, gapping, approximation
Cervical spine : AF flex, ext, side bend, rot with overpressure ( except for ext)

Question 23

Because the torso is so heavy how will the ROM testing be modified?

Answer 23

Only AF movement with with overpressure to determine end feel.

Question 24

When should you forgo any ROM in the spine?

Answer 24

When your cl is suffering from any neurological symptoms that suggest any degree of disc herniation.

Question 25

Should you do Active resisted ROM testing if your client has a possible herniated disc? What about AF ROM?

Answer 25

NO!

Should be OK as long as they aren’t in an acute flare up because then everything will hurt. (false positives)

Question 26

Walk through Active free testing for T/L spine.

Answer 26

Cl stands and tucks in chin to chest

forward bends as far as possible

Question 27

When a cl bends forward the movement is initiated by which muscle group and controlled by which other muscle group?

Answer 27

When the cl bend forward the action is started by to psoas/ abdominal muscles. The action is controlled by eccentric contraction of the sacrospinalis muscles and multifidus muscles.

Question 28

When a client bends forward the lumbar spine should transition from a healthy lordotic curve to what shape?

Answer 28

is should flatten out not go kyphotic.

Question 29

Walk through active free extension.

Answer 29

Client is standing he/she extends backward with the therapist stabilizing the pelvis.

Question 30

Walk through active free side bending

Answer 30

Cl standing s/he sidebends trying to reach down the side of their leg attempting to touch their knee.

Question 31

Walk through active trunk rotation.

Answer 31

Cl seated (to reduce movement of the pelvis) on table ( feet off the ground) cross arms over chest ( so they don’t used them to compensate). End range is noted when cl contralateral knee moves forward. Apply over pressure only if there is not pain. ( this can clarify any vague sensations that the client might have been feeling.)

Question 32

which part of the spine rotates the least due to facet orientation?

Answer 32

Lumbar